MEDICARE: BRIGHT HARBOR BEHAVIORAL CARE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1346127537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT HARBOR BEHAVIORAL CARE CORP

Provider Business Mailing Address
First Line	:	67 NW 183RD ST STE 107
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4516
Country	:	US
Telephone Number	:	786-872-5771
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 NW 183RD ST STE 107
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4516
Country	:	US
Telephone Number	:	786-872-5771
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA RODRIGUEZ RIBOT
Credential	:
Telephone Number	:	786-872-5771

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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